Flexible hysteroscopy in irregular uterine bleeding

Area of Science:

• Gynecology
• Diagnostic Procedures
• Women's Health

Background:

• Irregular uterine bleeding (IUB) is a common gynecological issue.
• Accurate diagnosis is crucial for effective management of IUB.
• Traditional diagnostic methods may have limitations.

Purpose of the Study:

• To evaluate the diagnostic capabilities of flexible hysteroscopy in women experiencing IUB.
• To compare hysteroscopy findings with subsequent dilatation and curettage (D&C) results.

Main Methods:

• 661 women with IUB underwent diagnostic flexible hysteroscopy.
• Procedures were performed using a 5 mm panoramic fibrohysteroscope.
• Hysteroscopy was followed by conventional D&C for histological analysis.

Main Results:

• Hysteroscopy identified various endometrial conditions, including normal endometrium (37.52%), hyperplasia/polyposis (45.39%), and suspected atypia/neoplasia (12.40%).
• D&C confirmed hormonal causes (81.39%), precancer/cancer lesions (9.98%), and other findings like myomas or retained products (4.69%).
• Hysteroscopy demonstrated a sensitivity of 74.07% and specificity of 90.61% compared to D&C.

Conclusions:

• Flexible hysteroscopy offers significant diagnostic potential for evaluating women with IUB.
• The procedure is safe, simple, and can be enhanced by direct biopsy for improved accuracy.
• Hysteroscopy provides a valuable tool for assessing the uterine cavity and guiding treatment decisions.